Provider Demographics
NPI:1427291822
Name:BECKHAM, PAM (MS ,LPC, NCC)
Entity type:Individual
Prefix:
First Name:PAM
Middle Name:
Last Name:BECKHAM
Suffix:
Gender:F
Credentials:MS ,LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LILY LN
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-7387
Mailing Address - Country:US
Mailing Address - Phone:770-312-3134
Mailing Address - Fax:
Practice Address - Street 1:40 LILY LN
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-7387
Practice Address - Country:US
Practice Address - Phone:770-312-3134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005303101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional